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目的:探讨瘢痕子宫经阴道切除术的可行性、手术方法和经验。方法:回顾性分析我院2004年1月至2009年5月间,107例瘢痕子宫阴式切除术患者(研究组),100例瘢痕子宫腹式切除术患者(对照组Ⅰ),以及同期100例无盆腔手术史非脱垂子宫阴式切除术患者(对照组Ⅱ)的临床资料,并进行对比研究。结果:三组患者年龄、子宫大小及盆腔基础疾病分布差异无显著性。研究组患者平均手术时间、平均术中出血量均低于对照组Ⅰ(分别为62 min,110 ml与101 min,150 ml),差异有统计学意义(P<0.01);研究组术后肛门排气时间、下床活动时间、住院时间短于对照组Ⅰ(P<0.01),与对照组Ⅱ相比差异无显著性(P>0.05);术后发热率较对照组Ⅰ减少(4.7%与13.0%),术后阴道残端异常发生率3组差异无显著性(P>0.05)。结论:非脱垂的瘢痕子宫经阴道切除术与腹式切除术相比,手术时间短,创伤小,住院时间少,并发症发生率低,但需掌握一定的手术技巧。
Objective: To investigate the feasibility, operation method and experience of transvaginal excision of scar. Methods: A retrospective analysis of 107 patients with uterine vaginal resection (study group) and 100 patients with uterine scar resection (control group Ⅰ) in our hospital from January 2004 to May 2009 and 100 Cases without pelvic surgery history of non-prolapsed uterine vaginal resection patients (control group Ⅱ) clinical data and comparative study. Results: There was no significant difference in the distribution of age, uterine size and pelvic underlying disease between the three groups. The mean operative time and average blood loss in study group were lower than those in control group Ⅰ (62 min, 110 ml and 101 min, 150 ml, respectively) (P <0.01) Exhalation time, ambulation time and length of hospital stay were shorter than those in control group Ⅰ (P <0.01), but no significant difference compared with control group Ⅱ (P> 0.05) And 13.0% respectively). There was no significant difference in the incidence of postoperative vaginal stump abnormalities among the three groups (P> 0.05). Conclusion: Non-prolapsed scar transvaginal hysterectomy compared with abdominal resection, the operation time is short, less trauma, less hospital stay, the complication rate is low, but need to master certain surgical skills.